pinna

CONGENITAL DISORDERS:

bat ear/lop ear - protruding,large concha,poor antihelix & scapha.

• Rx: surgical correction after 6yrs.

preauricular appendages- skin covered cartilaginous tags between tragus & mouth angle.

preauricular pit/sinus at helix root- incomplete tubercles fusion–>repeated inf–>purulent discharge.

anotia- first arch syndrome.

macrotia

microtia- major dev anomaly of EAM,Mear,Iear[deaf].

TRAUMATIC CONDITIONS:

haematoma- blood between cartilage & perichondrium from blunt trauma[boxers,wrestlers,rugby].

• clot organizes-CAULIFLOWER EAR
• infection–>perichondritis.

Rx

• aspiration,
• pressure dressing,
• incise+drain+pressure w/ dental rolls thr sutures,
• prophylactic antibiotics

lacerations- Rx:

• absorbable sutures-perichondrium[no stripping-avscular necrosis]
• nonabsorbable sutures-skin
• broad spectrum antibiotics-1wk

avulsion:

• w/ pedicle  Rx:reatteach
• complete  Rx:micrvascular surgical reimplantation, implant deskinned cartilage under postauricular skin for later reconstruction.

frost bite=erythema/edema/bullae/necrosis.

Rx:

• rewarm w/ moist 38-42 ~c cotton pledgets [causes pain from rapid heating :analgesics]
• superficial inf -0.5%AgNO3 , deep inf -sys antibiotics.
• protection to stop bullae rupture.
• after several mos[dead & living demarcated]- surgical debridgement.

keloid =from trauma/pierce of lobule/helix.

Rx:

• surgical excision+pre,post operative 600-800rads/local steroid inj to prevent recurrence.

INFLM DISORDERS:

perichondritis:

• mixed flora,psudomonas inf from-
  • sec to lacerations/haematoma/surgery.
  • extended  from otitis externa.
• early red,burn,pain,stiff.
• late- abscess between perichondrium[bv] & cartilage –>cartilage necrosis.

Rx:

• sys antibiotics, 4%Al Acetate compresses.
• drain absces + culture sensitivity , remove devitalised cartilage/antibiotic catheter drip for 7-10days.

autoimmune relapsing polychondritis [ear,septal,larynx,tracea,costal] =inflam,tender,stenotic.

• Rx: high dose sys steroid.